The Grant Taylor Memorial Lecture: 1991

by William J Schull, RERF Permanent Director

This article originally appeared in RERF Update 3(3):S1-S4, 1991. The annual Grant Taylor Lecture was established by John McGovern, Houston philanthropist and physician, in honor of Grant Taylor, who served as ABCC’s second director from 1949 to 1953. After his return to the US, Taylor joined the MD Anderson Cancer Center, University of Texas, where he chaired the Department of Pediatrics and later served as the director of continuing education. Since the 1991 lecture touches upon issues relevant to society as a whole and to Update’s readers in particular, an abridged version is included as a special insert to this issue. Schull is the director of the Genetics Centers, University of Texas Health Science Center, Houston.

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Is the role of science in society inherently pernicious, as some tend to think? The author suggests that `technological truth’ is hidden–not by the facts, but by the scientific community’s failure to communicate them clearly to an apprehensive but apathetic public.

On Monday, the 16th of July 1945, at 0529:45 AM, the firing circuit closed on the first test of a nuclear weapon. Trinity, as this test was code-named, was a formidable achievement. It was, in a sense, the ultimate proof of particle physics. But it was also the starting point of a trail of ineptitude and hypocrisy that reflects poorly on journalists, the public, scientists, and our elected representatives. Sweeping as this statement may seem, it is not meant to imply that all of the world’s current ills stem from the wartime splitting of an atom. Nonetheless, I do believe the events that have followed the splitting are emblematic of others either to come or already in motion, and that each and every one of us has contributed, directly or indirectly, to these sorry developments through a failure to inform ourselves adequately, to encourage reasoned debate of the problems that confront us, or to disseminate what is known.

 

 

The sequence of scientific discoveries that culminated in Trinity was born in a spirit of curiosity, not malevolence. Rutherford, who discovered the nucleus of the atom in 1911, did not believe that energy could be recovered from it. And the seminal contributions to nuclear physics of Enrico Fermi, Otto Frisch, Otto Hahn, Lise Meitner, and Fritz Strassman stemmed solely from an attempt to understand the puzzling results that arose when uranium, one of the heaviest of elements, was bombarded by neutrons. It would not be an overstatement to assert that without their curiosity contemporary biology and medicine would be very different. Virtually every major advance in the biomedical sciences in the past four decades has hinged on an experiment using radioactive isotopes. But, as Robert Crease and Nicholas Samios have written, “It is unfortunate that the beneficial effects of scientific discoveries often become so thoroughly integrated into the world that they are taken for granted, as part of its warp and woof, whereas the pernicious applications of scientific discoveries are often portrayed as representative of scientific activity itself” (Atlantic Monthly, January 1991, pp 80-88).

 

Journalists and the media

When this new age began, lay and scientific communities alike were generally ill-informed about the short- as well as the long-term consequences of exposure to ionizing radiation. The public obtained most of its knowledge through the printed word or radio. Journalists, specifically print journalists, were more influential than now, but unfortunately they produced few measured statements of what was and was not known. But ill-founded speculations abounded: Hiroshima and Nagasaki would be uninhabitable for centuries, an epidemic of misshapen monsters–animal and plant–would occur, a slow lingering death invariably faced those individuals who had fortuitously survived the immediate aftermath of these detonations. None of these came to pass nor were they to be expected.

These statements were not merely an aberration of the time; the same discredited allegations have been raised anew in connection with the Chernobyl accident. There are other instances that can be cited of a disregard for facts and a lack of concern for the truth. As an illustration, a recent Associated Press article appearing in Japan was headlined: “Nearly 2,000 incidents reported at US N-plants in 1990.” Since only 111 commercial nuclear reactors were operating in the United States in 1990, this would seem a sorry safety record indeed, and a headline calculated to unnerve the most stouthearted. But as further reading in the same article revealed, in only 38 of these 2,000 safety-related incidents was there concern about a potential threat to the health and safety of the public. Most of these so-called incidents involved violations of federal safety regulations; the most common being the failure to use a grounded electrical outlet. This fact was not made known to a wary and apprehensive public.

Now, when an accident does occur, the press immediately greets us with polarized views. One group seeks to deny or instantly minimize the danger, and the other to discredit information yet to be collected, lest it reveal the accident was not a matter of great public health concern. Even the recent, careful study of the International Atomic Energy Agency regarding Chernobyl was promptly characterized as “scientifically incompetent.” It did not support the scare tactics of those with special agendas. Whether this sensationalizing reflects the fact that few newspapers have bona fide science writers, who could be expected to understand and interpret the facts correctly, or an overriding compulsion to pander to that which sells, is arguable. More grievous to society than these ill-considered statements, however, has been the climate of distrust of our institutions, our technology, and one another that has been set into motion. Some years ago, for example, a major dam in China broke, and 250,000 people lost their lives, but little of this appeared in American newspapers. Are we to construe this as not newsworthy, or is this merely another instance of selective reporting?

The Public

Almost two centuries ago, Thomas Jefferson wrote: “I know of no safe depository of the ultimate powers of society but the people themselves; and if we think them not enlightened enough to exercise their control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion.” This laudable sentiment is not, however, an easy nor a simple matter to implement, particularly in an era when the public seems less able or inclined to read, and seeks its information through television in 30-second bits. It is not now a question of taking their discretion from them; they are surrendering it willingly to sources only marginally better informed.

Until the accident at Three Mile Island in 1980, and the subsequent one at Chernobyl in 1986, most individuals either ignored the risk associated with nuclear energy or presumed it was small. However, these two events dramatically changed perceptions of the safety of the nuclear power industry. What was previously accepted, almost blithely by most, is now seen as a hazard beyond entertaining, or even discussing. This makes reasoned debate about the role of nuclear power in global energy production virtually impossible. Nevertheless, as concern mounts about global warming and the use of fossil fuels, the role, if any, nuclear power can play–reconciling national needs with the inherent risks–must be examined. To do so requires an informed public, one acquainted with the factual bases on which an informed judgment must rest.

It is not clear how this state of understanding is to be achieved when the public perception of the risks of nuclear power are so muddled and confused. For example, some years ago members of the Oregon League of Women Voters were asked to rank their perceptions of the risk associated with 30 activities and technologies. (P Slovic, in: Proc 15th Annual Meeting of the National Council on Radiation Protection and Measurements, Bethesda, Md, NCRP, 1979, pp 34-56). Nuclear power was perceived to carry a risk even greater than that from the use of motor vehicles, yet the latter causes the death of more than 45,000 Americans each year, whereas fatalities attributable to nuclear power are so few as to be counted on one hand. Ironically, electric power was rated the most beneficial of these 30 activities and technologies, substantially higher than the availability of motor vehicles.

Similar surveys conducted in other countries have yielded similar results. For example, in France, respondents to a national survey in 1988 thought the danger associated with a nuclear power plant was greater than that in uranium mining, yet mining, whether for uranium or other ores, causes more deaths each year than occur in all nuclear power facilities without regard to country (MH Barny et al, Nucleaire et opinion publique en France: donnes sur les dechets radioactifs. Evolutions depuis 1977. Paris: Institut de Protection et de Suret* Nucleaire, DPS/SEGP, Note LSEES 90/10, 1990). Moreover, the risk associated with nuclear power plants is invariably seen as greater than that stemming from exposure to diagnostic or therapeutic X rays, but again, in fact, the risk of a second malignancy following X-ray therapy for a primary cancer is substantially higher than the risk of radiation-related cancer among workers in nuclear facilities.

The elements that define one’s perception of risk associated with a particular activity are still poorly known. However, it is clear that individual notions hinge on many factors, including whether the risk is seen as voluntary or involuntary, chronic or catastrophic, controllable or not controllable, old or new, immediate or delayed, fatal or not fatal, and so on. It is clear too that this perception is colored by one’s knowledge of the actual hazard. Surveys have shown that nuclear engineers are far less reluctant to live near a nuclear power facility than are environmentalists, and surely the former must have a better knowledge of the likelihood of an accident than the latter. Obviously in some manner the gap between the perception of risk and actuality must be closed.

It seems doubtful that education alone will be successful until we better understand how our perceptions are formed. While some opposition to an expansion of nuclear power has occurred in all countries in the last decade or so, it has been less organized and certainly less aggressive in France, which generates more nuclear energy relatively than any other country, and in Japan, where the opposition to nuclear weapons has been exceptionally vocal. What have these nations done, consciously or unconsciously, to bring this about? Their peoples are certainly not better informed. Does it, then, reflect a more autocratic bureaucracy? Or, in the case of Japan, is it attributable to the consensus seeking that characterizes so much of decision-making in this country?

 

Scientists and science

Scientists too have been remiss–most importantly, in failing to communicate the benefits and the hazards associated with nuclear energy in comprehensible language. This failure has created a fertile ground for rumors, misconceptions, and outright fabrications in spite of the knowledge that is available. Studies of the late occurring health effects of exposure to the atomic bombings of Hiroshima and Nagasaki began in 1948, have continued uninterrupted, and have provided a wealth of information.

The findings of these studies can be summarized simply: Mortality from a variety of cancers–leukemia and cancers of the breast, colon, esophagus, lung, ovary, thyroid, salivary glands, stomach, urinary bladder, and multiple myeloma–increase in frequency with increasing dose. An increase in mortality from the cancerous tumor of the lymph nodes, known as lymphoma, remains uncertain, and if the time from exposure to the development of this malignancy is long, as is true of multiple myeloma, the uncertainty may persist for some time.

Present evidence fails to suggest an increase in malignant brain tumors, and is equivocal with regard to tumors of the central nervous system other than the brain. Whether an increase in cancer of the liver occurs is unclear, as judged by the mortality findings. When the data are restricted to only those cancers known as primary, liver cancers do not increase significantly with dose; however, if the cancers termed “unspecified” are included, there is a dose-related increase. The liver is a common site of metastasis for cancers arising elsewhere, in the breast or lung, for example, and the unspecified tumors may be metastatic ones that should be assigned to other organs where an effect of radiation is known to occur.

No increase has been seen in deaths from cancers of the bone, gallbladder, nose and larynx, pancreas, pharynx, prostate, rectum, skin except melanoma, and the uterus.

Mortality from cancers other than leukemia increases significantly, generally when individuals reach the usual age of onset for a given cancer and the distribution of time from exposure to death does not differ by radiation dose, but it does depend upon the age of the individuals at the time of the bombings (ATB). The risk of cancer other than leukemia is higher among those individuals who were 0-9, or 10-19 years old ATB. Their risk has been declining, however, and significantly so among those aged 0-9 ATB. No increase has been seen in childhood cancers among the prenatally exposed, but cancers of later years are increased in frequency within this special group of survivors. The data are still limited, since only now are the prenatally exposed survivors reaching those ages in life when the natural rate of cancer increases dramatically. It will be a number of years therefore before the full impact of exposure on their risk can be assessed with the accuracy and reliability warranted.

These statements may have little meaning to the nonspecialist, but more substance can be given them by considering the additional cancers that have occurred among these groups as a consequence of their exposure. In the years from 1950-85, 202 individuals among some 76,000 under surveillance died of leukemia. About 59% of these deaths, or 119, were attributable to radiation. These same years saw 5,734 deaths from cancers other than leukemia. Approximately 8%, or 459, of these deaths were presumably due to radiation. The comparable figures for all 284,000 survivors identified in the 1950 census are 386 leukemia deaths–191 ascribable to radiation, and 10,421 deaths from malignancies other than leukemia of which 833 stemmed from exposure. These are estimates, of course, since it is presently impossible to distinguish a radiation-related cancer from one due to some other cause. However, most survivors who will die of cancer will do so as a result of the lives they lead–through smoking, drinking, and exposure to other as yet unidentified factors–and not from their exposure to atomic radiation.

Cancer is not the only risk. The most poignant is the increase in severe mental retardation among the prenatally exposed survivors, particularly those exposed between the 8th and the 15th weeks following fertilization. Almost three-fourths of the individuals exposed to 1 Gy or more are severely retarded mentally.

When these studies began, public concern over the possible genetic effects of exposure to atomic radiation was at least as great as that over cancer, and possibly greater. To most prospective parents the thought of producing a seriously malformed infant was troubling, but it was even more intimidating when coupled with the belief that the abnormality might have arisen through an avoidable exposure to ionizing radiation. As a result, no other human population has been scrutinized more closely, continuously, or thoroughly than the children of the survivors of the bombings of these two cities.

Various strategies to detect newly arisen mutations have been employed; these include a search for alterations in the frequency of occurrence of life-threatening or socially handicapping congenital defect and premature death, or of changes of a chromosomal nature, or in the biochemical structure or activity of a variety of cellular enzymes and proteins normally present in the serum. These strategies, though different, share common aims–to estimate the probability of mutation following exposure to ionizing radiation, and to determine the public health implications of an increase in the mutations measured. These various studies, however painstaking and thorough, serve these ends unequally well, for some measure the direct product of genes and others–albeit of substantial public health importance–examine characteristics considerably removed from the molecular or cellular level at which genes act. These facts notwithstanding, the data that have accumulated provide the clearest picture we have of transmitted genetic damage following exposure of human beings to ionizing radiation. But there emerges no unequivocal evidence of radiation-related genetic damage.

The absence of a significant effect should not be construed as evidence that mutations were not induced by parental exposure to atomic radiation. At least two reasons argue otherwise. First, mutations have been seen in every animal and plant species studied under suitable experimental conditions, and it would be contrary to reason to presume that human genes are not mutable when exposed to ionizing radiation. Second, the magnitude of a difference between two or more groups that can be detected statistically depends upon the number of observations available, the “natural” frequency of the event under scrutiny, and the difference between the groups that obtains. One can, therefore, ask how adequate has this study been, or to pose the question differently, how large a difference would have had to exist to be demonstrable with a study of 76,000 infants only half of whom had one or more exposed parents?

Suffice it to state that a clinical study of the kind described would detect a doubling of the rate of major congenital malformations, and an alteration in the stillbirth or neonatal death rates of approximately 1.8 times. Since major congenital defects of the kind to which we refer, those recognizable at or shortly after birth under the conditions of these examinations, normally occur in about one out of every 100 pregnancies that persist for at least 7 months of gestation, this says that if the risk had been changed to 1 in 50 as a result of parental exposure to ionizing radiation that fact would have been recognized. It is important to bear in mind, however, that the frequency of congenital defects one finds depends upon the clinical tools at one’s disposal, and the length of time the children are studied. Examinations conducted within days after the birth of an infant would not detect most cases of mental and motor retardation, nor would they be likely to identify many of those congenital defects of the heart that do not involve cyanosis and are commonly not detected until the infant becomes older.

As has been stated, at the outset of the studies in Hiroshima and Nagasaki, public concern about the possible genetic effects of exposure to atomic radiation was as great as that about cancer, and possibly greater. Over time, however, this emphasis has slowly shifted to more interest in cancer. This undoubtedly reflects the failure to find evidence of genetic damage, on the one hand, and the more dramatic findings on cancer, on the other. Understandably, but unfortunately, this has led to some failure to recognize that negative findings are no less noteworthy. But negative findings are more difficult to document. A single such study, particularly if it is based upon a relatively small sample, should be viewed askance. In the present instance, however, there is not merely one but numerous negative findings, and they are all based upon samples of considerable size. Nonetheless, ultimately their acceptance rests on the comprehensiveness of the study design, and the care and thoroughness with which that design has been implemented. This observation notwithstanding, negative findings should be seen as reassuring to the public, and in the specific case of the genetic studies, the findings argue forcefully against the fears of a devastating genetic effect on future generations.

These are the facts as we now know them. There is obviously much that is not known that is necessary to a rigorous estimation of the risks. We do not know the lifetime consequences of exposure–more than half of the survivors of the atomic bombings are still alive. We must project their risks from what we have seen to date. This requires not merely knowing that a particular cancer is increased as dose increases, but by how much at each dose. This rate of increase we know imperfectly. Moreover, projections can be made in a variety of ways, each yielding a somewhat different answer. It is not known which is the most appropriate and will not be known until the bulk of the survivors have died.

But the shortcomings of immediate concern lie not with the facts, but with the failure to communicate them adequately. No less importantly, however, there has been a change in the perception of the role of science in society that does not augur well. The success of the Manhattan Project has led to an increasing effort to manage scientific research as if it were a business whose survival depends upon a product rather than the advancement of knowledge. This has been especially noticeable in the national laboratories, but it is not unknown in academic institutions. There has been a proliferation of regulations without evaluation of their need or their impact on the intellectual atmosphere in which creative research occurs.

 

Our elected representatives

When the Manhattan Project began, its purpose, although unknown to most members of the US Congress, was clear–to construct, if possible, an atomic weapon. Once this was achieved and wartime hostilities had ceased, the nation was in need of a civil administrative structure to supervise the design and creation of nuclear weapons, to oversee the existing weapons facilities, and to encourage the development of nuclear power. To these ends in 1947 Congress approved the creation of an Atomic Energy Commission (AEC), and vested its oversight in a Joint Committee on Atomic Energy. Briefly, while the US appeared to be the sole possessor of nuclear weapons, matters went well, but with the blockade of Berlin in 1948, the first detonation of a Russian weapon in 1949, and the spread of the Cold War, matters worsened rapidly. National defense was dominated by the notion of nuclear deterrence, and this demanded more and larger weapons. Weapons design, fabrication, and testing were accelerated, and in the rush safety was compromised, although few knew the extent at the time. In retrospect, possibly as many as a million Americans, residents around nuclear weapons plants or test sites, may have been needlessly exposed to ionizing radiation because of the nuclear arms race. While it is presumed that these exposures were small and not injurious, some children living downwind of the Hanford facility in Washington, for example, may have ingested enough radioactive iodine to have a measurably increased risk of thyroid cancer.

Arguably the first manifestation of public dissatisfaction arose in the years of atmospheric testing when it was realized that the AEC was responsible not only for the measurement of levels of radioactivity at the Nevada Test Site itself, but off-site as well. A credulous public wondered whether the polluter could be trusted to accurately represent the extent of the contamination. To remedy this, Congress transferred responsibility for off-site monitoring to a newly created Bureau of Radiation Health within the Public Health Service. But the damage to credibility had already occurred. Soon there would be other changes. Our increasing dependence on foreign oil led to the creation of the Energy Research and Development Agency in 1975 and the incorporation of the activities of the AEC into this new agency. The latter was short-lived. In 1977, it was replaced by the Department of Energy.

With these changes came a greater intrusion of bureaucracy and politics, and a dissemination of regulatory and oversight responsibilities. Regulation of the commercial nuclear power establishment rests with the Nuclear Regulatory Commission; however, off the sites of these facilities regulations are formulated by the Environmental Protection Agency. Similarly, the Department of Energy is responsible for the safety of the facilities it manages, but off-site regulations are the province of the Environmental Protection Agency. This constant tinkering with the structure of the oversight agencies is not only prejudicial to their morale, but encourages a dilatory approach to difficult decisions. Although there are now more players, we still struggle with what to do about the contamination of the past and the disposal of radioactive wastes. The all too familiar syndrome “not in my backyard” stifles debate and action.

As energy consumption grows globally, and fears mount about the effects of continued use of fossil fuels on earth-warming, we can no longer temporize. A consensus must be reached on the role, if any, nuclear energy is to play in our future. To do so will require each of us to be more critical of what we read and hear, to examine the facts, and to think for ourselves rather than to be passive vessels into which the thoughts and prejudices of others are poured. Neither the proclamations of nuclear power advocates, on the one hand, nor those of the Friends of the Earth, on the other, are unprejudiced. These groups have their own agendas, and can advocate these equally shrilly, trading on the concerns of the uninformed or poorly informed. In short, we must ourselves actively seek the information on which an informed judgment can be made. This is not an impossible task. There are highly readable accounts of how nuclear energy is produced, the functions of the various agencies that are involved in regulatory activities, the kind and nature of the accidents that can occur, and the like. Similar primers exist to enlighten the public on the issues that attend the disposal of nuclear wastes. But are we, as members of the public, prepared to invest the time and energy required to inform our discretions?

Our recent history suggests this is problematic. Yet ultimately the only avenue to a sound and widely acceptable nuclear policy is through an informed and committed public, willing to exercise its collective rights and responsibilities.